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https://www.readbyqxmd.com/read/28222471/telemedizin-potenziale-in-der-notfallmedizin
#1
Jörg C Brokmann, Marc Felzen, Stefan K Beckers, Michael Czaplik, Frederik Hirsch, Sebastian Bergrath, Rolf Rossaint
The telemedical support and networking between health personnel and medical specialists increases the quality of supply also in the prehospital emergency care. Till now only for some tracer diagnosis specifically designed telemedical services were used. However, now a unique holistic telemedicine system, which can be used for the whole emergency spectrum as a supplementary feature has been developed. It can be used for the whole prehospital emergency care. The needfulness and meaningfulness of telemedicine as well as the important structural characteristics in prehospital emergency care are pictured...
February 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28221895/use-of-evidence-based-prostate-cancer-imaging-in-a-nongovernmental-integrated-health-care-system
#2
Ramzi G Salloum, Maureen O'Keeffe-Rosetti, Debra P Ritzwoller, Mark C Hornbrook, Jennifer Elston Lafata, Matthew E Nielsen
PURPOSE: The overuse of imaging, particularly for staging of low-risk prostate cancer, is well documented and widespread. The existing literature, which focuses on the elderly in fee-for-service settings, points to financial incentives as a driver of overuse and may not identify factors relevant to policy solutions within integrated health care systems, where physicians are salaried. METHODS: Imaging rates were analyzed among men with incident prostate cancer diagnosed between 2004 and 2011 within the Colorado and Northwest regions of Kaiser Permanente...
February 21, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28220257/impact-of-prior-breast-cancer-on-mode-of-delivery-and-pregnancy-associated-disorders-a-retrospective-analysis-of-subsequent-pregnancy-outcomes
#3
Louis Jacob, Matthias Kalder, Birgit Arabin, Karel Kostev
PURPOSE: The aim of this paper is to analyze the impact of prior breast cancer (BC) on mode of delivery and pregnancy-associated disorders. METHODS: A database from 262 German gynecological practices including 289,712 women between the ages of 18 and 45 with documented pregnancies between 2000 and 2014 was used to search for patients with a history of BC up to 10 years prior to pregnancy. A total of 165 patients with a history of BC were found and matched with 165 patients without a history of any cancer (1:1) by age, physician, obesity, and documented referral to a fertility center up to 12 months before the index pregnancy...
February 20, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28220198/-rationing-in-inpatient-psychiatric-care
#4
B Braun, P Brückner-Bozetti, M Lingenfelder, C Uhlmann, T Steinert
OBJECTIVE: This study examined whether and in which services in psychiatric institutions implicit rationing takes place from the perspective of doctors and nurses. METHODS: From October 2013 to the middle of 2014 we conducted a written and standardized survey among physicians/psychologists (n = 256) and nurses (n = 796) from eight psychiatric hospitals in Germany. RESULTS: Out of 11 clinical activities 4 judged as necessary, namely communication and interaction with patients and relatives, coordination of treatment with other professionals and adequate documentation of the treatment, were not carried out sufficiently or implicitly rationed by 42-59% of the surveyed physicians/psychologists...
February 20, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28217518/a-2016-clinical-practice-pattern-in-the-management-of-primary-hypothyroidism-among-doctors-from-different-clinical-specialties-in-new-delhi
#5
Vineet Surana, Sameer Aggarwal, Deepak Khandelwal, Rajiv Singla, Saptarshi Bhattacharya, Sachin Chittawar, Sanjay Kalra, Deep Dutta
BACKGROUND: This study aimed to document practices in managing hypothyroidism among doctors in New Delhi, with special focus on subclinical hypothyroidism, pregnancy, and old age, and to compare it with global practices. METHODS: During an academic program attended by 394 doctors, all participants were given a questionnaire designed based on thyroid practices survey done by Burch et al. to evaluate the practice patterns. Questions were based on evaluating doctor's preferred choices in diagnosis, therapy, and follow-up of hypothyroidism in different scenarios...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#6
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28216355/innovative-postmarket-device-evaluation-using-a-quality-registry-to-monitor-thoracic-endovascular-aortic-repair-in-the-treatment-of-aortic-dissection
#7
Adam W Beck, Joseph V Lombardi, Dorothy B Abel, J Pablo Morales, Danica Marinac-Dabic, Grace Wang, Ali Azizzadeh, John Kern, Mark Fillinger, Rodney White, Jack L Cronenwett, Richard P Cambria
OBJECTIVE: United States Food and Drug Administration (FDA)-mandated postapproval studies have long been a mainstay of the continued evaluation of high-risk medical devices after initial marketing approval; however, these studies often present challenges related to patient/physician recruitment and retention. Retrospective single-center studies also do not fully represent the spectrum of real-world performance nor are they likely to have a sufficiently large enough sample size to detect important signals...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28214491/relationship-between-patient-reported-symptoms-limitations-in-daily-activities-and-psychological-impact-in-varicose-veins
#8
Rajiv Mallick, Brajesh Kumar Lal, Claire Daugherty
OBJECTIVE: The objective of this study was to evaluate the relationship between patient-reported symptoms, functional limitations, and psychological impact of varicose veins (VVs) vs pathophysiologic mechanism, incorporating demographic and behavioral factors. METHODS: We conducted a pooled analysis from two clinical studies (Efficacy and Safety Study of Polidocanol Injectable Foam for the Treatment of Saphenofemoral Junction Incompetence [VANISH-1] and Polidocanol Endovenous Microfoam Versus Vehicle for the Treatment of Saphenofemoral Junction Incompetence [VANISH-2]) in patients with VVs (superficial venous reflux only)...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28210082/multitarget-stool-dna-tests-increases-colorectal-cancer-screening-among-previously-noncompliant-medicare-patients
#9
Mark Prince, Lynn Lester, Rupal Chiniwala, Barry Berger
AIM: To determine the uptake of noninvasive multitarget stool DNA (mt-sDNA) in a cohort of colorectal cancer (CRC) screening non-compliant average-risk Medicare patients. METHODS: This cross sectional primary care office-based study examined mt-sDNA uptake in routine clinical practice among 393 colorectal cancer screening non-compliant Medicare patients ages 50-85 ordered by 77 physicians in a multispecialty group practice (USMD Physician Services, Dallas, TX) from October, 2014-September, 2015...
January 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28209703/determining-rates-of-overweight-and-obese-status-in-children-using-electronic-medical-records-cross-sectional-study
#10
Catherine S Birken, Karen Tu, William Oud, Sarah Carsley, Miranda Hanna, Gerald Lebovic, Astrid Guttmann
OBJECTIVE: To determine the prevalence of overweight and obese status in children by age, sex, and visit type, using data from EMRALD(®) (Electronic Medical Record Administrative data Linked Database). DESIGN: Heights and weights were abstracted for children 0 to 19 years of age who had at least one well-child visit from January 2010 to December 2011. Using the most recent visit, the proportions and 95% CIs of patients defined as overweight and obese were compared by age group, sex, and visit type using the World Health Organization growth reference standards...
February 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28203590/surgeon-directed-cost-variation-in-isolated-rotator-cuff-repair
#11
E Bailey Terhune, Peter C Cannamela, Jared S Johnson, Charles D Saad, John Barnes, Janette Silbernagel, Thomas Faciszewski, Kevin G Shea
BACKGROUND: As value becomes a larger component of heath care decision making, cost data can be evaluated for regional and physician variation. Value is determined by outcome divided by cost, and reducing cost increases value for patients. "Third-party spend" items are individual selections by surgeons used to perform procedures. Cost data for third-party spend items provide surgeons and hospitals with important information regarding care value, potential cost-saving opportunities, and the total cost of ownership of specific clinical decisions...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28202206/retrospective-chart-analysis-of-concussion-discharge-instructions-in-the-emergency-department
#12
Allison D Lane, Matthew R Berkman, David Verbunker, Taylor Shekell, Michael Bouska, Lauren Barnett, Allie Keogh, Tomas Nuno, Uwe Stolz, Anna L Waterbrook
BACKGROUND: Recognition and diagnosis of concussion is increasing, but current research shows these patients are discharged from the emergency department (ED) with a wide variability of recommendations and instructions. OBJECTIVE: To assess the adequacy of documentation of discharge instructions given to patients discharged from the ED with concussions. METHODS: This was a quality-improvement study conducted at a University-based Level I trauma center...
February 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28201864/recurrent-contrast-induced-encephalopathy-following-coronary-angiography
#13
Roberto Spina, Neil Simon, Romesh Markus, David W M Muller, Krishna Kathir
Contrast-induced encephalopathy (CIE) is an acute and reversible neurological disturbance associated with the intra-arterial administration of iodinated contrast medium during cardiac catheterisation. It may manifest with encephalopathy, motor and sensory disturbances; vision disturbances, including cortical blindness, ophthalmoplegia, aphasia; and seizures. Disruption of the blood-brain barrier and direct neuronal toxicity are believed to be implicated in the pathophysiology of the syndrome. Symptoms appear soon after contrast administration and resolve completely within 24-48 h...
February 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28198722/triad-viii-nationwide-multicenter-evaluation-to-determine-whether-patient-video-testimonials-can-safely-help-ensure-appropriate-critical-versus-end-of-life-care
#14
Ferdinando L Mirarchi, Timothy E Cooney, Arvind Venkat, David Wang, Thaddeus M Pope, Abra L Fant, Stanley A Terman, Kevin M Klauer, Monica Williams-Murphy, Michael A Gisondi, Brian Clemency, Ankur A Doshi, Mari Siegel, Mary S Kraemer, Kate Aberger, Stephanie Harman, Neera Ahuja, Jestin N Carlson, Melody L Milliron, Kristopher K Hart, Chelsey D Gilbertson, Jason W Wilson, Larissa Mueller, Lori Brown, Bradley D Gordon
OBJECTIVE: End-of-life interventions should be predicated on consensus understanding of patient wishes. Written documents are not always understood; adding a video testimonial/message (VM) might improve clarity. Goals of this study were to (1) determine baseline rates of consensus in assigning code status and resuscitation decisions in critically ill scenarios and (2) determine whether adding a VM increases consensus. METHODS: We randomly assigned 2 web-based survey links to 1366 faculty and resident physicians at institutions with graduate medical education programs in emergency medicine, family practice, and internal medicine...
February 14, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28197620/measuring-practicing-clinicians-information-literacy-an-exploratory-analysis-in-the-context-of-panel-management
#15
Brian E Dixon, Katherine Barboza, Ashley E Jensen, Katelyn J Bennett, Scott E Sherman, Mark D Schwartz
BACKGROUND: As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. OBJECTIVES: This study explored information literacy, a set of skills required to effectively navigate population health information systems, among primary care providers in one Veterans' Affairs (VA) medical center. METHODS: Information literacy was assessed during an 8-month randomized trial that tested a population health (panel) management intervention...
February 15, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28196448/provider-perspectives-on-advance-care-planning-documentation-in-the-electronic-health-record
#16
Ellis Dillon, Judith Chuang, Atul Gupta, Sharon Tapper, Steve Lai, Peter Yu, Christine Ritchie, Ming Tai-Seale
CONTEXT: Advance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic. OBJECTIVES: In order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28194518/-chronic-pain-in-general-practice-results-from-pain-specialists
#17
A Heymanns, H Rudolf, H Schneider-Nutz, K Salem, K Strick, M Zenz
BACKGROUND: There is currently a lack of data on chronic pain in general practice. METHODS: Over a period of 2 years, data from 12,271 patients visiting a pain specialist on an outpatient basis were collected. All patients had documented their pain history (German pain questionnaire) via tablet/computer into a databank. RESULTS: Data from 12,246 patients from 30 pain clinics could be evaluated. The proportion of women was higher (67%). The majority of patients suffered from back pain (52%)...
February 13, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28188994/anxiety-disorder-among-rheumatoid-arthritis-patients-insights-from-real-life-data
#18
Abdulla Watad, Nicola L Bragazzi, Mohammad Adawi, Gali Aljadeff, Howard Amital, Doron Comaneshter, Arnon D Cohen, Daniela Amital
BACKGROUND: Psychiatric disorders occur in a considerable proportion of patients with rheumatoid arthritis (RA), often reflecting the difficulties of these patients in coping with a chronic debilitating disorder. AIM OF THE STUDY: To evaluate the proportion of anxiety disorder in RA patients using a large database analysis. METHODS: The study was designed as a case-control population-based study using data from the Clalit Health Services (CHS) database...
February 6, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28182962/an-observational-study-of-the-impact-of-genetic-testing-for-pain-perception-in-the-clinical-management-of-chronic-non-cancer-pain
#19
Maneesh Sharma, Svetlana Kantorovich, Chee Lee, Natasha Anand, John Blanchard, Eric T Fung, Brian Meshkin, Ashley Brenton, Steven Richeimer
OBJECTIVE: Pain levels are a key metric in clinical care. However, the assessment of pain is limited to basic questionnaires and physician interpretation, which yield subjective data. Genetic markers of pain sensitivity, such as single nucleotide polymorphisms in the catechol-O-methyltransferase gene, have been shown to be associated with pain perception and have been used to provide objective information about a patient's pain. The goal of this study was to determine if physician treatment adjustments based on genetic tests of pain perception resulted in improved outcomes for patients...
January 30, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28182607/advisory-committee-on-immunization-practices-recommended-immunization-schedule-for-children-and-adolescents-aged-18-years-or-younger-united-states-2017
#20
Candice L Robinson, José R Romero, Allison Kempe, Cynthia Pellegrini
In October 2016, the Advisory Committee on Immunization Practices (ACIP) approved the Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger-United States, 2017. The 2017 child and adolescent immunization schedule summarizes ACIP recommendations, including several changes from the 2016 immunization schedules, in three figures, and footnotes for the figures. These documents can be found on the CDC immunization schedule website (https://www.cdc.gov/vaccines/schedules/index.html)...
February 10, 2017: MMWR. Morbidity and Mortality Weekly Report
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